Meet Midlife
Joint pain and brain fog
Joint pain in midlife: is it menopause?
If your joints ache, you have plenty of company. When 10,739 postmenopausal women joined the Women’s Health Initiative estrogen-alone trial, about 77% reported joint pain and 40% reported joint swelling. All of them had undergone a hysterectomy, so they aren’t a perfect stand-in for every woman. For osteoarthritis of the hand, hip and knee, the 2019 American College of Rheumatology and Arthritis Foundation guideline strongly recommends several options that need no prescription, including exercise, tai chi and self-management programs.
This week: for two weeks, note which joints hurt and how long you’re stiff after you get up. The NIH’s arthritis institute lists stiffness lasting longer than 30 minutes as a common symptom of rheumatoid arthritis, and notes that RA often affects both sides of the body.
Ask your clinician: “My morning stiffness lasts more than half an hour. Should we check for rheumatoid arthritis before we put this down to menopause?”
Sources: Chlebowski RT et al., WHI estrogen-alone trial and joint symptoms, Menopause, 2013 (PubMed). Kolasinski SL et al., 2019 ACR/Arthritis Foundation osteoarthritis guideline, Arthritis Rheumatol, 2020 (PubMed). NIAMS, Rheumatoid Arthritis (niams.nih.gov). Read the guide →
Is this brain fog? Memory and focus in midlife
Most people score a little higher each time they retake the same memory test, because they learn it. The Study of Women’s Health Across the Nation (SWAN), a cohort study, retested 2,362 women over four years. During perimenopause, that learning boost stalled. After menopause it came back to premenopausal levels, and the researchers concluded the difficulties “may be time-limited.” The change showed up as missing improvement, not a sudden drop. And an observational study can’t predict how any one woman will feel.
This week: for two weeks, rate your fog each day next to your sleep and hot flashes on our tracker. Fog after a broken night tells a different story from fog after a good one.
Ask your clinician: “Could anything else be behind this, like my thyroid, low B12, a medication or my sleep?”
Sources: Greendale GA et al., menopause transition and cognitive performance (SWAN), Neurology, 2009 (PubMed). National Institute on Aging, Memory Problems, Forgetfulness, and Aging (nia.nih.gov). Read the guide →
Myth-buster: hormone therapy is not a memory treatment
The Menopause Society’s 2022 position statement says hormone therapy “is not recommended at any age to prevent or treat a decline in cognitive function or dementia.” Three large randomized trials found neutral effects on thinking when it was started early after menopause. Started after age 65, one combined regimen added 23 dementia cases per 10,000 person-years in the WHI Memory Study. The same statement still calls hormone therapy the most effective treatment for hot flashes and night sweats. That’s a separate question to take to your clinician.
Source: The Menopause Society, 2022 hormone therapy position statement, Menopause, 2022 (PubMed).
Meet Midlife is operated by Amberline LLC. Information for better conversations, not a diagnosis. This is research with sources, not medical advice. Talk to your clinician about your situation.